Uninsured can’t afford drugs, 40,000 new HIV infections

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Uninsured can’t afford drugs, 40,000 new HIV infections.

More than 80 percent of the 40,000 new HIV infections each year are spread by people who didn’t know they had the virus or were diagnosed but never received treatment, according to the Centers for Disease Control and Prevention.

The data, provided Monday in the CDC’s Vital Signs report, sheds new light on HIV outbreaks at a time when the Trump administration has asked Congress to allocate $291 million in new funds next year to begin work that would halt new HIV transmission within a decade. The report indicates that the healthcare system will have to improve not just at identifying who has HIV, but at making sure people who are infected are consistently getting medical care.

Dr. Jerome Adams, the surgeon general, said in a call with reporters Monday that without government action another 400,000 people would become infected with HIV in the next 10 years.

“Why now? We have the right data, we have the right tools, and we have the right leadership … to end the HIV epidemic in America,” he said.

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The latest study, which took data from 2016, found that 15 percent of people who have HIV in the U.S. do not know their status, and they are responsible for spreading roughly 40 percent of new infections. Another 23 percent of people with HIV have received their diagnosis but are not getting treatment. As a result, they spread roughly 43 percent of new infections every year.

To work toward ending HIV transmission in a decade, the Trump administration will focus on 48 counties in the U.S. where half of new outbreaks are concentrated. The administration will encourage the use of Truvada, a medication that prevents people from getting HIV, as well as antiretroviral medications that suppress the virus in people who are infected. After six months of the medication, people pose no risk of spreading the virus. The administration will also support needle exchange programs and condom use.

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“A goal that once seemed impossible is now within our reach,” Dr. Robert Redfield, CDC director, said on the call.

Past studies have shown that people often aren’t prescribed antiretrovirals after they receive an HIV diagnosis. Dr. Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention, said doctors may not yet be following new government guidelines to encourage people to receive the pills immediately after diagnosis. Some people also can’t afford the medication.

The medicines help the virus from progressing into AIDS, and prospects are best for people who take it early during their infection and take it every day as prescribed. Some medications require multiple pills a day, but there are versions of the medications that come in single-pill-a-day form.

Still, taking pills consistently is hard for people who are uninsured, even if only for a short time, as well as for people who use drugs or alcohol, and for people who are homeless or don’t have access to transportation to get to a pharmacy. The CDC study found that 11 percent of people who are receiving care, but did not achieve viral suppression, account for 20 percent of all HIV transmissions.

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“We will work with communities to develop a number of options to help people who want to get on treatment immediately,” McCray said. Redfield added that this would include working with a “non-traditional” public health workforce, meaning people who are trusted within their communities who can go directly into neighborhoods to help people manage their infection. Another example would be to let people receive HIV tests in the mail that they can do at home.

Antiretrovirals have drastically changed the outlook for someone with HIV, and half of the 1.1 million people who have HIV in the U.S. are taking such medications, according to the CDC. HIV used to have no treatment and caused the AIDS crisis during the 1980s, but the medications available now allow people to live a normal lifespan.

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